Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Fred David Dodge, LCSW

Individual provider Clinical Social Worker · NPI 1669117438

Fred David Dodge, LCSW is a Clinical Social Worker in Meridian, Idaho. Qualified in 2015, 11 years ago. Practices with Mental Health Specialty Group PA, a 679-clinician group and accepts Medicare assignment. Licensed in Idaho and Utah.

Years since qualifying
11
Licensed in
ID, UT
In the registry since
2022
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

2650 S Eagle Rd
Meridian, ID 83642-6725
Phone: (986) 200-4290
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW-40095 (ID)
Mental Health Counselor Taxonomy 101YM0800X · Licence 8851160-3501 (UT)

Record details

NPI number1669117438
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMay 4, 2022
Last updated in NPPESSeptember 21, 2026
Certification dateSeptember 21, 2026

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Mental Health Specialty Group Pa — 679 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Colleagues at Mental Health Specialty Group PA

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 679 clinicians in the practice; 12 are shown here.

Other providers in Meridian